xarelto (RIVAROXABAN)

What is Xarelto?

Xarelto is an anticoagulant used to prevent and treat blood clots, including conditions like deep vein thrombosis (DVT), pulmonary embolism (PE), and to reduce the risk of stroke in people with atrial fibrillation. It works by inhibiting Factor Xa, a key enzyme in the blood clotting process, preventing clot formation.

What is the usual dose of Xarelto?

For adults, the usual dose of Xarelto is:

• Atrial Fibrillation: 20 mg once daily.
• Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE):
• Post-Surgery Prophylaxis: 10 mg once daily.

For children, dosing is based on weight:

• Weight 20 to 29.9 kg: 2.5 mg twice daily.
• Weight 30 to 49.9 kg: 7.5 mg once daily.
• Weight ≥50 kg: 10 mg once daily.

Always consult a healthcare provider for personalized dosing

• Initial: 15 mg twice daily for the first 21 days.
• Maintenance: 20 mg once daily thereafter..

How do I take Xarelto?

Xarelto should be taken exactly as prescribed by a healthcare provider. For doses of 15 mg or higher, it should be taken with food to enhance absorption. There are no specific food restrictions, but it’s important to avoid excessive alcohol consumption as it may affect the medicine's effectiveness. Always take the medication at the same time each day for consistency.

For how long do I take Xarelto?

• Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): Usually prescribed for at least 3 months. Treatment may be extended based on individual risk factors.
• Post-Surgery Prophylaxis: Generally used for 2 to 5 weeks following hip or knee replacement surgery.
• Atrial Fibrillation: Often requires long-term treatment, potentially for life, depending on the patient's risk profile.

What disease or symptom is Xarelto used for?

Xarelto is a medication used to treat and prevent blood clots in the legs (deep vein thrombosis) and lungs (pulmonary embolism). It is also used to prevent these clots from recurring after initial treatment.

How long does it take for Xarelto to start working?

Xarelto starts working within a few hours of taking it, meaning its blood-thinning effects begin relatively soon after ingestion.

Is Xarelto effective?

Clinical trials have shown that Xarelto effectively reduces the risk of blood clots, stroke, and systemic embolism. In studies like the ROCKET AF trial, it demonstrated similar or superior efficacy compared to warfarin in preventing strokes in atrial fibrillation patients. Xarelto also proved effective in treating and preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) with a favorable safety profile.

How do I know if Xarelto is working?

The benefit of Xarelto is evaluated through clinical trials and regular monitoring of patient outcomes. Key measures include reduced incidence of blood clots, strokes, and pulmonary embolism (PE). In addition, blood tests may be used to monitor clotting function and assess the drug’s effectiveness, although Xarelto typically doesn’t require routine coagulation monitoring.

How does Xarelto work?

Xarelto works by inhibiting Factor Xa, an enzyme crucial for the blood clotting process. By blocking Factor Xa, it prevents the conversion of prothrombin to thrombin, reducing the formation of fibrin clots. This helps prevent and treat blood clots, reducing the risk of conditions like deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke.

Who should avoid taking Xarelto?

Xarelto should not be used in people with active bleeding, severe liver disease, or those who are allergic to it. It should also be avoided during pregnancy unless prescribed. Caution is required for individuals with kidney problems or those undergoing surgery, as Xarelto increases bleeding risk. It should not be combined with other blood thinners without medical supervision.

Can I take Xarelto with other prescription drugs?

Xarelto can interact with several prescription drugs, increasing the risk of bleeding. Notable interactions include:

1. Antiplatelet drugs (e.g., aspirin, clopidogrel)
2. Other anticoagulants (e.g., warfarin, heparin)
3. Antifungals (e.g., ketoconazole)
4. HIV medications (e.g., ritonavir)

Can Xarelto be taken safely while pregnant?

Xarelto is a medicine that should not be taken by pregnant women. It can cause bleeding problems for both the mother and the baby. If you are pregnant or planning to become pregnant, talk to your doctor about other treatment options.

Can Xarelto be taken safely while breastfeeding?

Talk to your doctor before taking Xarelto while breastfeeding. Xarelto passes into breast milk in small amounts, but it's unlikely to harm your baby. However, your doctor may recommend a different medicine with more information available on its safety during breastfeeding.

Is Xarelto safe for the elderly?

• Lower Doses Recommended: A dose of 10 mg once daily is often better tolerated and may reduce bleeding risks, especially in patients aged 80 and older.
• Increased Bleeding Risk: Elderly patients are at a higher risk for bleeding due to age-related factors such as renal impairment and increased coagulation factors.
• No Official Dose Adjustment: Current guidelines do not recommend specific dose adjustments for the elderly, but careful monitoring is essential.
• Individualized Therapy: Due to variability in tolerance and comorbidities, individualized dosing and regular reassessment of bleeding risks are crucial.

How should I store Xarelto?

Store the medication at normal room temperature between 68°F to 77°F (20°C to 25°C). It's okay if the temperature goes up to 86°F (30°C) or down to 59°F (15°C) for a short time. Do not freeze the medicine.

Does Xarelto make people tired or drowsy?

Xarelto is not commonly associated with tiredness or drowsiness. If you feel unusually fatigued, consult your doctor to rule out other causes, such as anemia or bleeding.

Does Xarelto cause stomach upset?

Yes, gastrointestinal side effects like nausea, abdominal pain, or indigestion may occur in less than 10% of users. Take the medicine with food to reduce discomfort and report severe symptoms to your doctor.

Does Xarelto affect sleep?

Sleep disturbances, such as insomnia, are not typical with Xarelto. If you notice sleep changes, discuss them with your doctor to explore potential causes or solutions.

Does Xarelto make it hard to think or concentrate?

Xarelto is not known to affect cognitive function. If you experience dizziness, difficulty concentrating, or memory issues, inform your doctor to investigate possible underlying causes.

Does Xarelto affect mood?

Mood changes, such as anxiety or irritability, are rare with Xarelto. Notify your doctor if you experience significant emotional changes during treatment.

Does Xarelto interfere with sexual function?

Xarelto does not typically cause sexual dysfunction. If you experience issues, consult your doctor to explore potential contributing factors.

Does Xarelto affect appetite?

Appetite changes are uncommon. If you notice a significant increase or decrease in appetite, let your doctor know to assess the cause.

Does Xarelto cause weight gain?

Weight gain is not commonly linked to Xarelto. If weight changes occur, discuss them with your doctor, as they could indicate other health issues.

Does Xarelto cause headaches?

Headaches are rare but may occur in less than 10% of users. Use over-the-counter pain relievers as recommended, and consult your doctor if headaches persist or worsen.

Does Xarelto limit driving?

Xarelto is unlikely to impair driving, but dizziness or lightheadedness can occur. Avoid driving if you feel unsteady and inform your doctor about these symptoms.

Is it safe to drink alcohol while taking Xarelto?

Avoid excessive alcohol consumption while on Xarelto, as it increases the risk of stomach irritation and bleeding. Occasional, moderate alcohol intake may be acceptable—consult your doctor for personalized advice.

Is it safe to drink coffee or tea while taking Xarelto?

Caffeinated beverages like coffee or tea are generally safe with Xarelto. However, if caffeine increases symptoms like heartburn, consider limiting consumption.

Is it safe to exercise while taking Xarelto?

Exercise is safe but avoid high-risk activities that might cause injury or bruising, as Xarelto increases bleeding risk. If you experience dizziness or unusual bleeding after physical activity, stop and consult your doctor.

What are the most common side effects of Xarelto?

A side effect is an unwanted or unexpected symptom caused by a medicine. For this medicine, common side effects may include nausea, which is feeling sick to your stomach, dizziness, which is feeling lightheaded or unsteady, headache, which is pain in the head, fatigue, which is feeling very tired, and dry mouth, which is a lack of saliva. The frequency of these side effects can vary, but they are generally considered common. It's important to note that when starting a new medicine, people might experience new symptoms that could be unrelated to the medicine, temporary, or due to another health issue. Always talk to a healthcare provider before stopping any medicine, as they can provide guidance on managing side effects and ensure your treatment is safe and effective.

Does Xarelto have adverse effects?

Adverse effects, which are unwanted or harmful reactions to a medicine, can occur with any medication. For this medicine, common adverse effects might include nausea, headache, dizziness, fatigue, and dry mouth. These effects can vary in how often they happen, but they are generally not severe. However, there are serious adverse effects that, although rare, need immediate medical attention. These might include severe allergic reactions, chest pain, or difficulty breathing. It's crucial to report any new or worsening symptoms to a healthcare provider. Never stop taking a medicine without first consulting a healthcare professional, as they can provide guidance on how to manage side effects safely.

Is Xarelto addictive?

This medicine does not have any known potential for dependence or addiction. It is considered safe in terms of habit-forming properties. Therefore, there is no need to worry about developing a physical or psychological dependence on this medication. However, it is always important to follow the prescribed dosage and instructions provided by your healthcare provider to ensure safe and effective use. If you have any concerns or questions about your medication, it is best to discuss them with your doctor or pharmacist.

Does Xarelto have any safety warnings?

To determine if a medicine has safety warnings, you should first check the prescription information provided with the medicine. This information often includes a section on warnings and precautions. For example, if a medicine has a warning about causing drowsiness, the rationale is that it affects the central nervous system, which is the part of the body that controls alertness. The possible consequence is that it could impair your ability to drive or operate machinery safely. Symptoms to monitor include feeling unusually sleepy or having trouble staying awake. If you notice these symptoms, it's important to avoid activities that require full attention and consult your healthcare provider for advice.

Is it safe to stop Xarelto?

To determine if it's safe to stop a medicine, first identify its purpose. If it's for managing a chronic condition like hypertension or diabetes, stopping it suddenly can lead to serious health risks, such as uncontrolled blood pressure or blood sugar levels. If the medicine is for symptomatic relief or treating a temporary condition, like an infection, stopping it might lead to a return of symptoms or incomplete treatment. Some medicines can cause withdrawal or rebound symptoms if stopped abruptly, which means symptoms can return worse than before. In some cases, stopping a medicine suddenly can be life-threatening. Therefore, it's crucial to consult with a doctor before making any changes to your medication regimen. They can provide guidance on how to safely discontinue or adjust your medication.

How do I dispose of Xarelto?

If you can, bring unused medicines to a drug take-back program or collection site at a pharmacy or hospital. They will dispose of this medicine properly so they don't harm people or the environment. If you can't find a take-back program, you can throw most medicines in the trash at home. But first, take them out of their original containers, mix them with something undesirable like used coffee grounds, seal the mixture in a plastic bag and throw it away.

What are Xarelto possible harms and risks?

Common side effects of Xarelto include bleeding, bruising, headache, dizziness, and stomach upset. Serious adverse effects may include severe bleeding, such as in the brain or stomach, allergic reactions, liver problems, and kidney dysfunction. If signs of bleeding or unusual bruising occur, medical attention should be sought immediately.